Life events and bipolar disorder: Implications from biological theories

Although a number of studies suggest that stressful life events play a role in bipolar disorder, methodological flaws impose serious limitations on this literature. Nonetheless, better designed studies indicate that life events influence the course of bipolar disorder. Little is known, however, about the nature of events that are of particular importance to this disorder. Given the strong biological vulnerability and the unique clinical aspects of bipolar disorder, certain forms of stress may have stronger interactions with vulnerability characteristics. Three major biological theories of bipolar disorder are discussed, with particular attention to their implications for investigations of life events. Although tenuous, these models suggest that greater attention needs to be paid to particular dimensions of life events and the course of disorder.